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What is the main focus when caring for a client experiencing delirium?
Which statement best describes the approach to communication with a delirious client?
When might medications be considered for a client with delirium?
What setting is recommended for a client experiencing delirium?
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Which medication class is typically used for clients experiencing withdrawal that leads to delirium?
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Which of the following is a key feature of delirium?
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Which condition is commonly associated with causing delirium in elderly patients?
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What does delirium NOT typically cause?
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What is a critical factor in the resolution of delirium?
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How is delirium distinguished from other neurocognitive disorders?
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Which of the following can be considered a predisposing factor for delirium?
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Which symptom is NOT typically associated with delirium?
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Which of the following symptoms is NOT commonly associated with delirium?
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Which of the following is best practice in care for clients with neurocognitive disorders, including delirium?
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What is a crucial first step in the treatment of delirium?
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Which of the following groups is at the highest risk for developing delirium?
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Delirium can cause fluctuations in which aspect of a patient's condition?
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Which of the following statements about delirium is true?
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How might delirium affect someone's physical appearance?
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Which of the following symptoms best represents altered levels of consciousness in delirium?
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Individuals experiencing hallucinations should have what type of attention during an acute delirious episode?
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Study Notes
Neurocognitive Disorders Overview
- Neurocognitive disorders involve significant cognitive or memory deficits representing a notable change in functioning.
- Changed classification from DSM-IV to DSM-5: from delirium, dementia, and other amnesic disorders to categories of delirium and mild to major neurocognitive disorders.
- Care focuses on promoting dignity, preserving quality of life, and supporting families and caregivers.
Delirium Characteristics
- Delirium is an acute disturbance in cognition, marked by short-term confusion, excitement, disorientation, and clouded consciousness.
- Duration of delirium can range from hours to days, and it is typically reversible if the underlying cause is identified and treated.
Causes of Delirium
- Common predisposing factors include:
- Infections (e.g., urinary tract infections)
- High fevers and febrile illnesses
- Head injuries
- Low sodium levels
- Post-operative anesthesia, particularly in elderly patients
- Age increases risk, particularly for individuals 65 years and older.
Symptoms of Delirium
- Symptoms vary but often include:
- Difficulty sustaining attention; distractibility
- Disorganized thinking and rambling or irrelevant speech
- Disorientation to time and place; impaired recent memory
- Delusions and hallucinations
- Fluctuating levels of consciousness, from comatose to hyper-vigilant
- Agitation and restlessness or, conversely, apathy
- Emotional instability: fear, anger, anxiety
- Physical symptoms: tachycardia, high blood pressure, flushed face, dilated pupils
Treatment Approaches for Delirium
- First step: Identify and treat underlying causes (e.g., infections, electrolyte imbalances).
- Essential to ensure patient safety, especially during hallucinations.
- Continuous presence and reassurance are vital; reorient patients about their surroundings.
- Maintain a calm environment with minimized stimuli.
- Clear and calm communication is critical.
Medication Considerations
- Medications primarily reserved for reversing symptoms:
- Low-dose antipsychotics may be necessary for agitation and aggression.
- Benzodiazepines can be used for substance withdrawal.
- Short-acting medications like Ativan may be utilized for safety.
Key Takeaway
- Understanding and addressing delirium is crucial in clinical settings, with recognition of its symptoms, causes, and treatment strategies being essential for effective patient care.
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Description
This quiz covers neurocognitive disorders with a focus on delirium. We will discuss the significant cognitive deficits associated with these disorders and the changes made from DSM-IV to DSM-V. Understand the implications of these diagnoses on functioning and memory.
